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01/31/12

  10:48:22 am, by MedBen5   , 219 words,  
Categories: News, Health Plan Management

People Divided On Reform Legislation, But Like Key Elements

A new Harris Interactive/HealthDay survey reveals that key provisions of the Affordable Care Act are increasingly finding favor with most Americans.

HealthDay News (via MedicineNet.com) reports that people remain sharply divided over the overall legislation, mainly along partisan lines – most Democrats support it, while most Republicans want it repealed. But major elements of the bill have gained in popularity, including:

  • allowing children to stay on their parents’ insurance plans until they turn 26 – 57% in January 2012 vs. 55% in November 2010.
  • preventing insurance companies from denying coverage to those already sick – 71% vs. 64%.
  • creating insurance exchanges where people can shop for insurance – 59% vs. 51%.
  • providing tax credits to small businesses to help pay for their employees’ insurance – 70% vs. 60%.
  • requiring all employers with 50 or more employees to offer insurance to their employees or pay a penalty – 53% vs. 48%.
  • requiring research to measure the effectiveness of different treatments – 53% vs. 44%.
  • creating a new Independent Payment Advisory Board to limit the growth of Medicare spending – 38% vs. 32%.

One provision that has the masses have definitely not embraced is the individual mandate – only 19% of those polled support requiring most Americans to buy health insurance or pay a tax penalty.

The poll also found that 55% of respondents believe that health care reform should be addressed at the state level, rather than federally.

  10:04:00 am, by MedBen5   , 186 words,  
Categories: News, Wellness

Calories Trump Fat, Carbs And Protein, Diet Study Suggests

Dieting need not come down to how much fat, carbs or protein you consume – calories are what counts, says a new scientific study.

According to Reuters, researchers randomly assigned several hundred overweight or obese people to one of four diets: average protein, low fat and higher carbs; high protein, low fat, and higher carbs; average protein, high fat and lower carbs; or high protein, high fat and lower carbs. Each of the diets was designed to eliminate 750 calories a day from the people’s energy needs.

After six months, researchers found that participants had lost over nine pounds of fat and nearly five pounds of lean mass. A two-year follow-up revealed that, on average, people maintained a weight loss of eight pounds. But across-the-board losses were similar regardless of what diet was assigned.

“If you’re happier doing it low fat, or happier doing it low carb, this paper says it’s OK to do it either way. They were equally successful,” said Christopher Gardner, a Stanford University professor who was not involved in the study. Finding a diet you can stick with is more important, he added.

01/30/12

  05:39:02 pm, by MedBen5   , 190 words,  
Categories: News, Wellness, Health Plan Management

U.S. Cancer Screenings Remain Below Target Levels

If you’ve put off a cancer screening, you’re not only doing yourself a disservice – you’re also disappointing your friends in the federal government.

According to WebMD, a new Centers for Disease Control and Prevention report says that screening rates for breast, cervical, and colorectal cancer remain below target levels set by federal officials in the Healthy People 2020 initiative:

  • About 75% of eligible women received mammograms over the past decade. The Healthy People target rate is 81%.
  • Cervical cancer screenings have remained consistent of late, with about 80% of women having Pap tests – but still below the 93% goal.
  • While colorectal cancer screenings are up from previous studies, only 59% of men and women got tested in 2010. That’s well short of the 70% target screening rate for both sexes.

The federal government doesn’t set target numbers for prostate cancer, so those sceening rates weren’t included.

At MedBen, we encourage all adults to get their age-appropriate cancer tests. A reminder for our Worksite Wellness members: you can monitor you compliance critical wellness examinations, including all four cancer screenings mentioned above, by visiting the MedBen Access website and clicking on the Wellness Plan link under “My Plan”.

  04:45:42 pm, by MedBen5   , 257 words,  
Categories: News, Health Plan Management

President -- And A Candidate -- Weigh In On Individual Mandate

Two health care reform news notes to begin the week:

  • Reuters reports that the Obama administration has presented a written brief to the Supreme Court, which argues that even if the individual mandate is found unconstitutional, almost all the rest of the Affordable Care Act can still function properly.

    “Many provisions of the act, focused on controlling costs, improving public health and other objectives, have no connection to insurance coverage at all,” Solicitor General Donald Verrilli wrote in the brief. Only the provisions that bar insurers from rejecting an applicant because of pre-existing conditions, and from charging higher premiums based on a person’s medical history, would have to be removed from the law.

  • If the administration’s attorneys hadn’t already thought up a valid justification for the individual mandate, they got one this weekend from a surprising source: Republican presidential nominee Mitt Romney.

    NPR reports that at a GOP debate in Jacksonville, Florida, Romney defended the introduction of a 2006 Massachusetts law which required most state residents to buy health insurance or pay a tax penality. Romney was governor at the time the law was passed.

    “If you don’t want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn’t have insurance, then we have to care for them in the hospitals, give them free care,” said Romney. “So we said, no more, no more free riders. We are insisting on personal responsibility. Either get the insurance or help pay for your care.”

  12:19:17 pm, by MedBen5   , 134 words,  
Categories: News, Prescription, Wellness

FDA Approves First Once-Weekly Diabetes Drug

The third time’s the charm for the diabetes drug Bydureon. MedPage Today reports that the Food and Drug Administation has approved the once-weekly injection for type 2 diabetes – the first such treatment to get the green light.

Drugmakers Amylin and Alkermes submitted Bydureon (exenatide extended-release) for FDA review in 2009, but approval was twice delayed due to questons about the manufacturing process and a possible cardiovascular side effect. The agency did make approval contingent upon the drugmakers putting together a strategy to address concerns over acute pancreatitis and potential risk of thyroid cancer.

Common side effects of Bydureon include nausea, diarrhea, upper respiratory tract infection, and injection site nodules. But earlier trials showed that the drug promotes weight loss rather than gain, and shows better glycemic control than with the once-daily version of exenatide (Byetta).

  11:14:31 am, by MedBen5   , 159 words,  
Categories: News, Health Plan Management

Referrals To Specialists Almost Doubled In Last Decade

Specialists lately have experienced a boom in referral business. The New York Times reports that doctors decided to send their patients to specialists and other doctors 9.3% of the time, compared with 4.8% a decade earlier, according to a new Harvard Medical School study.

“This evolution in care patterns may be playing a role in the rising trajectory of health care spending in the U.S., as referrals to specialists may lead to increased use of higher-cost services,” the researchers said. They add that while sometimes the referrals lead to necessary treatments, in other cases the additional tests and procedures do little to benefit patients.

How to explain this trend? “Medicine is becoming increasingly technologically sophisticated,” as the number of specialists and subspecialists has risen, said study co-author Dr. Bruce E. Landon. But he also atrributes it to the “tyranny of the 15-minute visit,” as primary care physicians have less time and resources to delve into any potentially complicated medical condition.

01/27/12

  05:41:01 pm, by MedBen5   , 278 words,  
Categories: Wellness, Health Plan Management

Cost, Complexity Among Reasons For Cancer Care Need

MedBen recently introduced comprehensive care management through Accountable Care Solutions (ACS). These programs were designed by medical professionals to control expenses for three costly and pervasive chronic conditions: Cardiovascular, Kidney Care and Oncology, or cancer care.

In a recent e-newsletter, inVentiv Medical Management, MedBen’s ACS partner, highlighted three reasons why cancer care management is so important:

  • Rising Costs: Double what it was 20 years ago, the cost of treating cancer is expected to rise by at least 27% in the next 10 years. With an estimated 1.5 million+ new cancer cases diagnosed last year (NiH 2010 study) and with costs for cancer care nearing $367 billion, competent and appropriate cancer care management has never been more vital.
  • Innovations Fuel Complexity: Cancer care is evolving thanks to research and development, and patients and providers want access to the best care. Yet the complexity of the more than 300 cancer types and frequent innovations in treatment require continuous education and understanding of the risks and benefits of care decisions. Therefore, cancer treatment benefits from expert, balanced medical management to promote cost effective, safe, and integrated care to patients.
  • Lack of Evidence Based Care: Depending on the type of cancer, initial diagnoses are incorrect up to 70% of the time. Further, up to 36% of care is not evidence-based. As such, outcomes are historically inconsistent and include issues of safety, such as adverse events that trigger hospitalizations and ER visits.

Comprehensive Oncology Care Management begins at the time of diagnosis and prior to therapy. ACS provides care resources during therapy to empower patients and caregivers, and provides claims surveillance to realize cost savings after therapy.

To learn more, contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  05:06:46 pm, by MedBen5   , 234 words,  
Categories: News, Health Plan Management

Most Poll Respondents Against Individual Mandate

The latest opinion poll by the Kaiser Family Foundation found that 54% of respondents feel that the Supreme Court should rule unconstitutional the individual mandate, The Wall Street Journal Health Blog reports.

Only 17% say that the provision requiring most Americans to buy health insurance should stand. The remaining 29% said they didn’t know or didn’t want to answer.

In other health care reform news:

  • During a Daily Show interview, Health and Human Services Secretary Kathleen Sebelius stated that if the Supreme Court does strike down the individual mandate, they are other ways to convince healthy people to carry coverage. “[T]he mandate’s the fastest way to do it, and it just says, basically, everybody’s got some responsibility. But there are other ways to encourage people to come in,” she said.

    According to Healthwatch blog, Sebelius also thinks that businesses will continue to provide coverage to employees even after insurance exchanges become available.

  • Healthwatch also reports that former senator Norm Coleman, an adviser to Mitch Romney, predicted that should a Republican win the presidency this November, the Affordable Care Act would not be repealed. “You can’t whole-cloth throw it out. But you can substantially change what’s been done,” he told BioCentury This Week television.

    Romney’s campaign feels differently. “With all due respect to Sen. Coleman, he’s wrong,” campaign spokeswoman Andrea Saul said via e-mail. “Gov. Romney can and will repeal Obamacare and is committed to doing so.”

  04:34:02 pm, by MedBen5   , 235 words,  
Categories: Prescription, Wellness

Doctor Argues For Tougher Supplement Rules

The Food and Drug Administration needs to enact more stringent safeguards to protect the users of dietary supplements, according to a physician writing in the New England Journal of Medicine.

Pieter A. Cohen, MD, of Harvard Medical School writes that the more than 100 million Americans who annually buy vitamins, minerals, herbal ingredients, amino acids and other natural products presume that they are “both safe and effective". But weak FDA oversight of supplements provides no such reassurances.

In an article about Cohen’s essay, MedPage Today notes that ingredients used and sold in supplements prior to 1994 can be legally marketed without proof of safety or efficacy. A law called the Dietary Supplement Health and Education Act (DSHEA) requires manufacturers of any ingredient introduced after 1994 to provide the FDA with evidence supporting “a reasonable expectation of safety.” But Cohen says that part of the law “has thus far not been enforced.”

There are currently over 55,000 supplements on the market, 51,000 of which were introduced after DSHEA became law. But since 1994, the FDA has received notification for just 170 new supplement ingredients – “undoubtedly a small fraction of the ingredients for which safety data should have been submitted,” Cohen writes.

Last year, the FDA did issue draft guidance regarding information supplement manufacturers must submit to the agency. Cohen says the guidance “provides a thoughtful framework” and is a step in the right direction, but further measures are needed to protect consumers.

01/26/12

  05:00:42 pm, by MedBen5   , 208 words,  
Categories: News, Wellness

Too Much Overtime Increases Depression Risk, Study Says

Putting in overtime at work may impress the boss but does no favors to your mental disposition, a new study suggests.

Health.com reports that researchers followed over 2,000 British employees for six years, and found that workers who stayed at the office an average of 11 hours per day were more than twice as likely to develop depression than their colleagues who stuck to an 8-hour schedule. The risk remained constant even when such factors as workplace support, alcohol use and smoking were taken into account.

An worker’s position on the job ladder also impacted how he or she responded to longer hours. Junior and mid-level employees were more prone to depression than executives who burned the midnight oil. That’s likely due to the amount of control higher-ups have over their own work, said Alan Gelenberg, M.D., chair of the psychiatry department of Pennsylvania State University.

“I do mostly what I want to do, and when I put in an extra hard week, it’s my choice,” said Gelenberg, who was not involved in the study.

The researchers theorize that for workers lower on the food chain, long hours could create family or relationship conflicts that contribute to depression. Job insecurity and sleep deprivation may also be factors.

  03:48:53 pm, by MedBen5   , 199 words,  
Categories: News, Wellness, Health Plan Management

Federal Government Rejects Church Exemption For Contraceptive Coverage

One of the more controversial provisions of the Affordable Care Act is the requirement that health insurance plans cover contraceptive for women at no cost. Last week, the Obama administration rejected an exemption request by the Roman Catholic Church for employees of Catholic hospitals, colleges and charities.

The New York Times reports that federal officials did grant one minor concession: Church-affiliated organizations have until August 1, 2013 to comply with the requirement – one year longer that most other employers and insurers. Also, certain “religious employers", such as houses of worship, would be exempt, provided they exclusively employ or serve people of a single faith.

In deciding whether or not to grant an exemption, President Obama heard personal appeals by leaders of the Roman Catholic Church. He also considered the arguments of family planning advocates and experts on women’s health, who have long championed inexpensive access to birth control.

Kathleen Sebelius, the Secretary of Health and Human Services, said the ruling “strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services.” Archbishop Timothy M. Dolan of New York reponded that “the president is saying we have a year to figure out how to violate our consciences.”

01/25/12

  01:15:55 pm, by MedBen5   , 187 words,  
Categories: News, Wellness

Better Diabetic Treatment Linked To Fewer Amputations

Better treatment for diabetics are likely responsible for a dramatic decrease in foot and leg amputations, new government research finds. The Associated Press reports that the rate has fallen by more than half since the mid-1990s.

According to MayoClinic.com, diabetics can suffer from nerve damage and poor blood circulation that make the feet vulnerable to ulcers. If these ulcers go untreated, they can cause severe damage to tissues and bone – potentially necessitating surgical removal of a toe, foot or part of a leg.

The comprehensive study by the Centers for Disease Control and Prevention determined that for older diabetics – the population segment most suspectible to foot ulcers – amputations dropped from more that 11 to about 4 per 1,000 people. Officials noted that between 1988 and 2008, a greater proportion of diabetics got annual foot exams, and cited proper disease management as the main reason for the decline in amputations.

As the obesity rate has increased in the U.S., incidents of Type 2 diabetes have risen accordingly. But better treatment has led to declines in complications of the disease, including blindness and kidney failure in addition to amputations.

  11:54:48 am, by MedBen5   , 157 words,  
Categories: News, Health Plan Management

Little Mention Of Health Reform In State Of The Union Address

Health care reform got short shrift at last night’s State of the Union address by President Barack Obama. Medscape reports. In his 70-minute speech, he mentioned either “health care” or “health insurance” just 3 times, compared to 6 references in 2011 and 10 in 2010.

In his comments, Obama defended the Affordable Care Act by taking a couple jabs at health insurers: “I will not go back to the days when health insurance companies had unchecked power to cancel your policy, deny you coverage, or charge women differently from men.”

The President also shot back against the accusation the health care law represents socialized medicine medicine, by noting that it “relies on a reformed private market, not a government program.”

Article author Robert Lowes speculated that the Obama and his administration lawyers may be “saving their words for the Supreme Court in late March,” or that his silence may have reflected frustration with his ongoing squirmishes with Congressional Republicans about the ACA.

01/24/12

  05:28:18 pm, by MedBen5   , 291 words,  
Categories: News, Wellness, Health Plan Management

There's Gold In Them Thar Snores

NPR recently examined the growing use of overnight tests to diagnose apnea. The number of accredited sleep labs in the U.S. has quadrupled over the past decade, and critics are worried that testing for the condition may be over-prescribed.

Apnea – abnormal pauses in breathing that can lead to snoring, restness sleep and low blood oxygen levels – may increase the risk of heart disease, dementia and other serious illness. The condition has become more common as our population has grown older and more obese.

Traditionally, apnea patients have worked with their family physican to decide on a treatment. A CPAP machine, which helps keep a snorer’s airway open during sleep, is sometimes necessary. In many cases, however, simply losing weight or sleeping on one’s side may help to reduce the condition.

But increasingly, patients are bypassing their doctors entirely and heading straight to the sleep lab – at a cost of upwards of $1,900 a night. And two-night lab stays – one for testing, the second to try the CPAP machine – are not unusual.

As sleep labs have become more lucrative, insurer spending on apnea treatment has jumped accordingly. Medicare payments for sleep testing increased from $62 million in 2001 to $235 million in 2009, according to the Office of the Inspector General.

“We are spending more and more money on sleep testing and treatment, and like anything else in health care, there are unscrupulous people out there who are more than happy to do testing and treatment that might be of questionable value,” says Dr. Fred Holt, an expert on fraud and abuse. “This might be because of naiveté on the part of the physician, or unfortunately, it could be done for the sake of improving the cash flow of the business.”

01/20/12

  04:55:41 pm, by MedBen5   , 216 words,  
Categories: Health Plan Management

Defining "Health" Is Key To Cost Savings, Family Doctor Says

On the KevinMD.com blog, author Kohar Jones, MD poses two fundamental questions: What should be the stated aim of health care in America? And where would we need to put our money to reach that aim?

Jones finds curious the aims of health care as defined by the Center for Medicare and Medicaid Services: improve the experience of care, better the health of populations, and reduce the per capita costs of health care. As a family doctor, she believes her aims should be to prevent disease, promote health and cure sickness as needed. And the goals aren’t wholly compatible.

So what is the true purpose of a health care system? The answer matters, Jones says:

“How we define ‘health’ and what services we define as part of the ‘health system’ changes the way our society allocates scarce resources. Right now, our society devotes an enormous portion of our budget to the medical system – curing sickness and keeping people from dying. A medical system and a health system, however, are two different things.

“If we redefine a health system as any system within our society that delivers the goods that promote or destroy health, we can restructure our funding priorities to promote population health rather than individual medicine.”

Read the rest of Jones’ thoughts here.

  04:26:22 pm, by MedBen5   , 244 words,  
Categories: Wellness

Take Extra Precautions When Exercising In Cold Weather

Let’s get this out the way: People who exercise outdoors in cold weather aren’t crazy. They much prefer the term “eccentric".

But seriously, outdoor exercise during the winter is great for those who want to escape the confines of a stuffy gym. The lower temperature can be an effective pick-me-up, expecially for those who tend to get overheated when working out indoors. But prolonged exposure to the cold does require certain steps to stay safe, warns Dr. Cedric X. Bryant, chief science officer at the American Council on Exercise,.

Chief among the risks of winter workouts is hypothermia, an excessive loss of body heat. Symptoms of hypothemia range from shivering to slurred speech, and can cause the victim to drift into unconsciousness.

Bryant offers these safety tips for colder-weather exercise (via HealthDay News):

  • Wear layers of clothing to better control your body heat while exercising.
  • Wear a hat or helmet. When the temperature hits freezing, about 50% of your body heat can escape through your head.
  • Wear gloves and warm footwear. When the temperature drops, blood shifts away from the extremities to the center of the body to protect the internal organs, so it can be difficult to keep hands and feet warm.
  • Check the wind chill factor (a combination of air temperature and wind) before exercising. If it’s below minus 20 degrees, exposed skin is in danger. Wear a scarf or mask over your nose and mouth, to warm the air before you inhale it.

01/19/12

  06:30:19 pm, by MedBen5   , 200 words,  
Categories: News, Wellness

Study: About Half Of Patients Receive Recommended Preventive Services

Only about 1 in 5 American adults have an yearly checkup, according to a study appearing in the upcoming issue of American Journal of Preventive Medicine. And of those who do, just over half receive or are advised of recommended preventive health services.

According to Medical Xpress:

“The researchers captured audio recordings of 484 office visits by patients between the ages of 50 and 80 by 64 primary care physicians over a 2-year period in southeast Michigan. The goal was to see how often physicians delivered 19 national guideline-recommended preventive services, such as screening tests for cancer and hypertension, counseling on tobacco and alcohol use, and immunizations to patients who were eligible and due.

“Of the 2,662 services due during those visits, 54 percent were delivered. Those most likely to be given were screening tests for colorectal cancer (92.9 percent), hypertension (92 percent), and breast cancer (88.9 percent)… [P]atients were least likely to receive counseling about aspirin use, diet, flu immunization and vision screening.”

MedBen believes that an annual physical is one of the cornerstones of better health. We encourage our clients to visit their family doctors for regular preventive care, and discuss the preventive services that are appropriate for them. Additional information about recommended services is available at HealthCare.gov.

  04:22:02 pm, by MedBen5   , 169 words,  
Categories: Prescription, Wellness

Follow Rx Instructions To Avoid Negative Food Interactions

Some medications tolerate food with no problem. Others… well, let’s say if they don’t get along, there’s a good chance you’ll know in no uncertain terms.

Not that the combination of food and certain drugs will necessarily result in a physical reaction. The effectiveness of some medications can get diluted when taken immediately before or after a meal.

The American Academy of Family Physicians offers these tips to avoid negative drug-food interactions (via HealthDay News):

  • Always read the label on your medications; ask questions of the pharmacist if you don’t understand something or aren’t sure.
  • Follow all label instructions and warnings on both prescription and over-the-counter medications.
  • Take any medication with a full glass of water, unless your doctor has advised differently.
  • Don’t stir a medication with food or break open a capsule, unless your doctor has told you to do so.
  • Don’t take any medication at the same time as you take vitamins.
  • Don’t mix a medication in a hot drink, and never take a medication with alcohol.
  01:40:05 pm, by MedBen5   , 229 words,  
Categories: News, Health Plan Management

Over Half Of U.S. States Moving Forward On Exchanges, While Others Hold

Over half of U.S. states have taken at least preliminary action in establishing a health insurance exchange as mandated by the Affordable Care Act, according to a new report by the Department of Health and Human Services.

Reuters reports that 14 states have enacted legislation or already have the authority in place to set up regulated insurance markets, while an equal number have acted through executive orders or authorized studies aimed at demonstrating their value.

Six other states, including Ohio, have shown “no significant activity” toward creating exchanges. And Wisconsin brought the number up to seven yesterday when Gov. Scott Walker declined $37 million from the federal government to help implement that state’s exchange.

The foot-dragging in these states isn’t necessarily due to political posturing, though that likely plays a role. More to the point, health care reform faces an uncertain future in 2012. With a pending Supreme Court ruling on the individual mandate and a November presidential election, some states are waiting to see what shape the ACA will be in when the year is over.

One problem with the strategy: Assuming the reform law makes it through 2012 intact, states would have to scramble to meet a January 1, 2013 deadline to act on an exchange or cede control to the federal government. However, Obama administration officials have said they will work with states who miss the deadline to ensure their participation.

  12:52:07 pm, by MedBen5   , 205 words,  
Categories: News, Wellness

Obesity Rates Slow, But One-Third Of U.S. Adults Still Overweight

Good news… Americans aren’t getting any bigger!

Bad news… we aren’t getting any smaller, either.

The Wall Street Journal Health Blog reports that adult male waistlines have held steady since 2003, according to a new study based on data from the Centers for Disease Control and Prevention. Women have done even better, with no notable increase in obesity rates since 1999.

But what accounts for the slowdown in growth? Experts aren’t certain. Study author Katherine Flegal, a CDC epidemiologist, and her colleagues cite multiple possibilities, such as an expansion of the food supply, energy imbalance, or the possible effect of environmental endocrine disruptors. Nor do the researchers have any idea if the slowdown is permanent, or if obesity rates could spike again.

Of course, this positive trend doesn’t negate the realty that more than one-third of adult U.S. residents are still overweight. And childhood obesity also remains a crisis – about one in six kids are overweight.

To address the latter problem, the Affordable Care Act now requires health insurers and employers to pay the cost of screening children for obesity and providing them with appropriate counseling. The New York Times recently examined various efforts being made to help kids achieve and maintain a healthier weight.

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